HCPCS T2004
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
N-et commerc carrier pass
Low
$0
Average
$33
Median
$23
High
$165
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Aetna fee schedule · outpatient · +4 other terms | 20 | $23 | $54 | $52 | 95% | — | $23 – $228 |
| 2 | Aetna Better Health fee schedule · inpatient · +1 other terms | 7 | $23 | $23 | — | — | — | $23 – $23 |
| 3 | Humana fee schedule · inpatient · +1 other terms | 5 | $23 | $23 | — | — | — | $23 – $23 |
| 4 | UnitedHealthcare facility · fee schedule · outpatient | 4 | $5 | $5 | — | — | — | $5 – $5 |
| 5 | First Health professional · fee schedule · both | 3 | $25 | $25 | — | — | — | $25 – $25 |
| 6 | Blue Cross Blue Shield fee schedule · outpatient · +1 other terms | 2 | $0 | $0 | — | — | — | $0 – $0 |
| 7 | Molina facility · fee schedule · outpatient | 2 | $16 | $16 | $3 | 17% | — | $13 – $18 |
| 8 | Anthem facility · fee schedule · outpatient · +1 other terms | 1 | $0 | $0 | — | — | — | $0 – $0 |
| 9 | Bcbs Id facility · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 10 | Bcbs La facility · fee schedule · outpatient | 1 | $0 | $0 | — | — | — | $0 – $0 |
← Hospitals reporting HCPCS T2004 · Snapshot 20261113T090226Z-3ce6c0b8